The role of advisory groups in the organisational structure of Ministry of Health

Birutė Mikulskienė, Birutė Pitrėnaitė, Danguolė Jankauskienė

Abstract

Public participation as an approach to health policy decision making refers to a democratic component of “institutional design of partnership governance”. The practice of policy formation inevitably triggers networks of external stakeholders and tends to change into a flexible organisational structure which recognises the value added of the knowledge that networks generate. Seeking to depolarize new trends of spontaneous policy networking with an existing hierarchical institutional structure, and find out the renewed role of democratic representatives, the practice of network recognition at the ministerial level needs to be explored. Research seeks to evaluate whether the policy making environment at Ministry of Health is adopted to integrate the network paradigm and to explore the level of stakeholder participation. The research is drawn on the cases of participatory decision-making groups, consensus-building groups that operated during 2007 and 2010 at the Ministry of Health of Lithuania. The research methodology engages a social network analysis for participation measurement and semi-structural interview for participation practice evaluation. The network analysis and network visualisation were processed by UCINET software. The total research data set covers temporary institutional arrangements and makes a network of 1005nodes with 1764 relationships that represent individual participation facts. Participatory groups were employed more than twice as less frequently in 2010 than in 2007. The social network analysis of the members that participate in problem solution processes lets us measure the prevalence and the boundaries of participatory policy practice. Empirical studies of the evolution of the network characteristics of the groups exhibit a stable practice of using interrelation with stakeholders in the policy network. A decision making group as a temporary organisational structure is employed with the diverse purpose: to manage stakeholder input, to burst consultation, to align proper decision, to diminishing confrontation. The equilibrium between dominant policy actors with high interest representation abilities and the stakes that are not expressed and conceptualized make a second challenge that needs to be solved by designing the organisational framework.